However, since risk selection is driven by enrollee choice, which is largely a function of enrollee perceptions of their plan characteristics, the self-reported plan type is the preferred indicator of health plan type for our purposes.

The study found that HMO enrollee hospital costs were only 55 percent of the cost of FFS enrollees in the year prior to joining an HMO ($693 versus $1,260 per beneficiary), and that the HMO enrollees who disenrolled and returned to FFS Medicare incurred hospital costs that were double the costs incurred by FFS enrollees ($644 versus $322 per beneficiary) in the first three months after enrollment.

The potential for undercounting may be caused by one or more of several factors: (1) the record for a dual enrollee may have been missing from either the EDB or the MAX file, (2) SSN may have been missing in the MAX file, or (3) there may have been errors or number transpositions in the recorded SSN.

To compare adjusted mortality rates of TEFRA-risk HMO enrollees and disenrollees with rates of beneficiaries enrolled in the Medicare fee-for-service sector (FFS), and to compare the time until death for decedents in these three groups.

To address possible unobserved differences between recent and established enrollees, models are estimated just with recent enrollees who stay enrolled in the program for at least 5 months and we subset the established enrollee sample to those who were enrolled in SCHIP closer to the time period during which children in the recent enrollee sample were entering SCHIP.

Table 1 compares per eligible payments of the dually eligible with non-dually eligible Medicaid enrollees based on an analysis of Federal fiscal year (FFY) 2002 Medicaid Statistical Information System (MSIS) data.

All content on this website, including dictionary, thesaurus, literature, geography, and other reference data is for informational purposes only. This information should not be considered complete, up to date, and is not intended to be used in place of a visit, consultation, or advice of a legal, medical, or any other professional.